High cholesterol is the leading modifiable risk factor for heart attacks and stroke. Our specialist lipid clinic offers comprehensive cholesterol assessment, personalised LDL targets, and access to the latest therapies.
Cardiovascular Risk Management
Raised LDL cholesterol silently builds up in artery walls for decades before causing a heart attack or stroke. Most Irish patients are not at their ESC-recommended LDL target.
At our lipid clinic, Dr Kalyar calculates your SCORE2 cardiovascular risk, reviews your full lipid profile (total cholesterol, LDL, HDL, triglycerides, apoB), and creates a personalised treatment plan with LDL targets based on ESC 2021 guidelines.
Conditions Managed
Treatment Options
What Is Measured
A standard lipid profile reports total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. The number that drives most treatment decisions is LDL cholesterol, because lowering it reduces cardiovascular events in direct proportion to the reduction achieved. Non-HDL cholesterol (total minus HDL) is an equally useful target and does not require fasting. Where the picture is unclear — a strong family history, borderline decisions, or triglyceride levels that make LDL hard to calculate — Dr Kalyar may add ApoB, which counts the actual number of atherogenic particles, and lipoprotein(a), an inherited, largely fixed risk factor that is measured once in a lifetime and is raised in roughly one in five people.
Targets are not one-size-fits-all. They are set by your overall cardiovascular risk: for people at very high risk — established cardiovascular disease, diabetes with end-organ damage, or familial hypercholesterolaemia — the European Society of Cardiology recommends an LDL below 1.4 mmol/L; for high risk, below 1.8 mmol/L; for moderate risk, below 2.6 mmol/L. Risk in people without established disease is estimated with the SCORE2 algorithm, and the target follows from the risk band rather than from the cholesterol number alone.
Assessment & Treatment
The Assessment Covers
Treatment Options
Book
Dr Kalyar, Consultant Interventional Cardiologist (IMC 102093). Saturday & Sunday appointments. No GP referral required.
No. Dr Kalyar (Consultant Interventional Cardiologist, IMC 102093) accepts self-referrals. Bring any recent blood test results including your lipid profile.
Familial hypercholesterolaemia (FH) is a genetic condition causing very high LDL cholesterol from birth. It affects 1 in 250 people in Ireland and is seriously under-diagnosed. It requires specialist assessment and lifelong treatment.
For most purposes, no. Non-fasting lipid profiles are now recommended for routine assessment because total cholesterol, LDL, HDL and non-HDL change very little with eating. Fasting is only needed when triglycerides are very high, when LDL has to be calculated rather than measured directly, or when a specific fasting glucose is required at the same time. Dr Kalyar will tell you which applies before your appointment, and any add-on tests such as Lp(a) or ApoB can be taken from the same sample.
Familial hypercholesterolaemia (FH) is an inherited condition, most often caused by a fault in the LDL-receptor gene, that produces very high LDL cholesterol from birth and, untreated, leads to premature coronary artery disease. It affects roughly 1 in 250 people in Ireland and the majority are undiagnosed. Diagnosis uses the LDL level together with personal and family history of early heart disease and physical signs such as tendon xanthomas, scored with a tool such as the Dutch Lipid Clinic Network criteria, and confirmed where possible with genetic testing. Identifying FH changes both your treatment targets and triggers cascade screening of first-degree relatives.
Usually not. True statin intolerance affecting all statins at any dose is uncommon; most people who have had muscle symptoms can tolerate a different statin, a lower dose, or alternate-day dosing, often combined with ezetimibe to reach target. Dr Kalyar will take a careful history, check for contributing factors such as vitamin D deficiency, thyroid disease and interacting medicines, and where genuine intolerance is confirmed will use non-statin options including ezetimibe, bempedoic acid or a PCSK9 inhibitor. The aim is to get LDL to target with whatever combination you tolerate.
Yes. If you bring recent blood results and any cardiovascular imaging — a CT calcium score, for example — Dr Kalyar can interpret them in the context of your full risk profile at the first consultation, calculate your SCORE2 risk, set a personalised LDL target and agree a treatment and monitoring plan, with the details sent to your GP. Repeat or additional bloods, if needed, are arranged locally to you.